Thursday , August 11 2022

What you need to know about the role your skin plays


Food allergies are on the rise around the world, starting with minor discomfort to possible sudden death and warning of an "allergy epidemic". The most severe form of an allergic reaction – anaphylaxis – can occur several times or without warning. The reasons for the rise of allergies are complex, but it is now known that the skin plays an important role as a guardian of the immune system.

Human skin is a protective barrier that provides dynamic coverage, ensuring that essential liquids (including water, proteins and minerals) remain in place, while harmful substances remain outside. The skin barrier is structural – like a brick wall – but it is also active and active, constantly sensing and reacting to the outside environment. This barrier consists of several layers of interconnected human cells, plus a multitude of microbes, fine organisms that live on the surface of healthy skin.

The skin forms an uninterrupted surface on the outside surface of the body, which easily interacts with the mucous membrane of the mouth and gut. Human cells are normally fed into food through the mouth, but the body can also be exposed to food on the surface of the skin.

The immune system – cells and tissues that work together to defend the body against potentially harmful viruses, bacteria and foreign substances – can react very differently when food first meets through the skin instead of through the mouth. This is because "missed" skin can confuse the ability of the immune system to recognize harmless substances.

Mice and people

It has been shown that mice exposed to white or peanut through the skin develop allergic reactions or anaphylaxis to these foods when they are eaten. Food allergy can develop in the same way.

When food is consumed, tolerance develops normally, which means there is no immune response. But when the skin leaks due to defective genes or when the skin is damaged by a condition such as eczema, food allergens may pass. This stimulates the cells of the immune system in the skin, which release the chemical signals of the attack. Then, next time they encounter certain foods, the cells are filled to cause an allergic reaction.

Read more: More people are experiencing serious food allergies than ever before

The "Leakiness" baby's skin shortly after birth (measured by the amount of water that evaporates from the surface) can predict the risk of food allergy at the age of two years. And recent research has shown that people with food allergies have molecular evidence that their skin is leaking and that they have reacted, even if the skin is normal.

Treatment and prevention

In an emergency, food allergy is treated with drugs that suppress the most dangerous characteristics of the anaphylactic response: low blood pressure and airway obstruction. Adrenaline (which is applied outside the hospital by an auto-injector with "pen") brings blood vessels to tighten – in order to maintain blood pressure – while bronchodilators cause the opening of the airway. Steroid treatment can reduce the harmful effects of a pre-emptive immune response. Corticosteroids are also used to limit the production of inflammatory signals in the blood and throughout the body.

Parents and caregivers often ask what they can do to prevent the development of food allergy, especially if there is a history of family allergies. Inkuiring About Tolerance, or "EAT" study, showed that the introduction of peanut and eggs into a baby's three-month old baby could reduce the likelihood of allergy to this food. The protective effect was less clear in other common foods such as milk, fish, wheat and sesame. This may be because smaller quantities of this food are consumed.

Skin condition such as eczema that breaks the surface of the skin is often associated with food allergies.

Another ongoing study aims to determine whether the use of moisturizing agents (known as emollients) on babies can improve the skin barrier to prevent eczema and food allergies. The results are impatiently expected, but further research will be needed to clarify whether – and how – food allergy can be prevented.

In the meantime, the British government continues to advise that babies should be exclusively breastfed up to six months of age. Although it is not known whether breastfeeding protects against allergy to food, it is clear that breast milk can provide many health benefits for the baby and mother.

Some people grow from their food allergies, but for others it becomes a lifelong burden on the caregiving avoidance of nutritious foods. Attempts to prevent any accidental exposure can collapse with catastrophic consequences, such as the case with teenager Natasa Ednan-Laperouse, who had a sesame allergy and died of a heart attack after eating a bag that he did not know contained the seeds of sesame seeds.

While accidental exposure to food can be very dangerous, immunotherapy – the deliberate use of nutrients on the surface of healthy skin – is tested in clinical trials to treat peanut and milk allergy.

Greater understanding of the causes of allergy will provide an opportunity to develop new treatments – and our skin can provide a pathway to prevention, as well as treatment for life-threatening reactions.

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